🎯 Clinical Trials: The mRS is the gold-standard functional outcome measure in stroke research. It grades recovery from 0 (no symptoms) to 6 (death), allowing comparison of treatment efficacy in thrombolysis, thrombectomy, and rehabilitation studies.
📊 Epidemiology: Widely used in population stroke registries to track disability-adjusted outcomes, healthcare utilisation, and recovery rates across health systems.
🏥 Clinical Practice: Routinely applied in UK stroke units to evaluate functional independence, plan discharge, and benchmark against Sentinel Stroke National Audit Programme (SSNAP) data.

🧾 Assessment: Modified Rankin Scale (mRS)

Score	Description
0	No symptoms at all.
1	No significant disability despite symptoms; able to carry out all usual duties and activities.
2	Slight disability; unable to carry out all previous activities but able to look after own affairs without assistance.
3	Moderate disability; requires some help but able to walk unassisted.
4	Moderately severe disability; unable to walk or attend to bodily needs without help.
5	Severe disability; bedridden, incontinent, requiring constant nursing care.
6	Dead.

💪 Patient Care and Rehabilitation

🧭 Rehabilitation Planning: The mRS score directs the intensity and goals of therapy — from early mobilisation (mRS 3–4) to home-based adaptations (mRS 1–2).
🏠 Discharge Decisions: Scores guide safe transfer — e.g. mRS 0–2 often suitable for home discharge; higher scores may need inpatient rehab or long-term care.
📈 Monitoring Progress: Serial mRS scoring provides a simple, reproducible measure of functional recovery over weeks and months post-stroke.

💷 Health Economics and Policy

⚖️ Cost-Effectiveness Analysis: mRS data underpin QALY (Quality-Adjusted Life Year) calculations and NICE cost-benefit modelling for stroke treatments such as thrombectomy and alteplase.
🏥 Service Evaluation: NHS trusts use mRS outcomes to evaluate rehabilitation quality and compare stroke pathway performance nationally.

🧠 Teaching Commentary

The mRS integrates neurological deficit with real-world function — making it a pragmatic endpoint for both trials and bedside use.
Although simple, inter-observer variability is common; use the Rankin Structured Interview for consistency.
Combining mRS with the NIH Stroke Scale (NIHSS) offers a powerful dual view: NIHSS = impairment, mRS = disability.
Always reassess before discharge — functional status can improve significantly within days post-stroke, altering care planning.

📚 References

van Swieten JC et al. Interobserver agreement for the assessment of handicap in stroke patients. Stroke. 1988.
Rankin J. Cerebral vascular accidents in patients over the age of 60. Scott Med J. 1957.
NICE NG128: Stroke and transient ischaemic attack in over 16s (2023 update).
Sentinel Stroke National Audit Programme (SSNAP) – Clinical Audit 2024.

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Modified Rankin Score

🧠 Uses of the Modified Rankin Scale (mRS): Assessment of Stroke Outcomes

🧾 Assessment: Modified Rankin Scale (mRS)

💪 Patient Care and Rehabilitation

💷 Health Economics and Policy

🧠 Teaching Commentary

📚 References

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